84 year old woman with spells of right upper limb weakness and numbness Teaching NeuroImages...
-
Upload
barry-williams -
Category
Documents
-
view
212 -
download
0
Transcript of 84 year old woman with spells of right upper limb weakness and numbness Teaching NeuroImages...
84 year old woman with spells of right upper limb weakness and numbness
Teaching NeuroImagesNeurology
Resident and Fellow Section
© 2014 American Academy of Neurology
Vignette
• History of: – Prior strokes to left parietal and right occipital
lobes.– Metastatic breast cancer with skull involvement.
O’Gorman et al© 2014 American Academy of Neurology
Imaging
O’Gorman et al© 2014 American Academy of Neurology
Imaging
O’Gorman et al© 2014 American Academy of Neurology
EEG pattern associated with a skull osteolytic lesion in breast cancer
• Breach effect or breach rhythm – a focal increase in amplitude of alpha, beta and mu
rhythms detected at or near the site of a bony skull defect.[1]
– Usually associated with surgical skull defects.– Also seen in osteolytic lesions of the skull.[2]– No association with epilepsy.– EEG alteration may be confused with focal
epileptiform discharges.• Final diagnosis: focal seizure
O’Gorman et al© 2014 American Academy of Neurology